• Image field 229
  • DIRECT SELLER APPLICATION

    Enagic India Kangen Water Pvt. Ltd.
  • Steps to be taken for Placing The Order of The Machine

  • Image field 235
  • Image field 236
  • Image field 237
  • Image field 238
  • Image field 202
  • DIRECT SELLER APPLICATION

    Enagic India Kangen Water Pvt. Ltd.
  • This Form is Applicable Only For India

  • Describe Yourself*
  • PRINCIPAL INFORMATION*
  • PO - PRINCIPAL INFORMATION
  • Date of Birth
     - -
  • Gender
  • Previous ID
  • PO Date of Birth
     - -
  • PO Gender
  • ADDRESS DETAILS - Postal Address

    Please provide your complete postal address with pin code and attach a valid address proof along with this application form. Your application will be rejected without valid address proof.
  • Shipping Address

  • SHIPPING ADDRESS DETAILS - Please provide details below*
  • DETAILS OF BANK ACCOUNT

    (Must be a Ruppe Denominated Account)
  • Upload your Cancelled Bank Cheque
  • PERMANENT ACCOUNT NUMBER (PAN) & GSTIN DETAILS

    Note: In case of GSTN Not applicable, it is mandatory to submit GSTN Declaration with application form.
  • Upload your GST Certificate (in case of GSTN)
  • APPLICANT'S SIGNATURE DATE
     - -
  • SPONSOR'S SIGNATURE DATE
     - -
  • Image field 230
  • PRODUCT OFFERED

  • PRODUCTS*
  • PO PRODUCTS
  • SOUTH - AP, Telangana, Karnataka, Pondicherry, Kerala, Tamilnadu*
  • WEST - Gujarat, Goa, Maharastra, Madhya Pradesh, Chhattisgarh*
  • NORTH - Chandigarh, Delhi, Haryana, Himachal Pradesh, Punjab, Rajasthan, Uttar Pradesh, Uttarakhand*
  • EAST - Bihar, Jharkhand, Orissa, West Bengal*
  • NORTH EAST - Arunachal Pradesh, Assam, Manipur, Tripura, Meghalaya, Mizoram, Nagaland, Sikkim*
  • J & K - Jammu and Kashmir*
  • PORT BLAIR - Andaman & Nicobar Island / Special Destination*
  • PAYMENT METHOD

  • Select your Payment Method*
  • Payment Type*
  • Transaction Details
  • Date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Date
     - -
    2 digit day, 2 digit month, 4 digit year
  • CHEQUE DEPOSIT DATE
     - -
    2 digit day, 2 digit month, 4 digit year
  • Upload your Proof of Payment Screen Shot
  • Upload your 2nd Proof of Payment Screen Shot
  • Upload your 3rd Proof of Payment Screen Shot
  • DOCUMENT UPLOAD

  • Photo Identity Proof (Attach photocopy)*
  • Aadhar Card (Front Side)*
  • Aadhar Card (Back Side)*
  • PAN Card*
  • Passport/Election Card/Driving License
  • Select Files
    Cancelof
  • PO - Photo Identity Proof (Attach photocopy)
  • DECLARATION AND UNDERTAKING

    Individual / Sole Proprietor / Managing Partner / Authorized Director
  • TODAY'S DATE
     - -
  • TODAY'S DATE
     - -
    2 digit day, 2 digit month, 4 digit year
  • Following Documents are required for Private Limited Company
    Kinldy send us on kangen@snehworld.com

     

    1. Direct Seller Form with PO (with seal and signature)
    2. Corporate Authorization Form (with seal and signature)
    3. Certificate of Incorporation/Registration
    4. MOA (Complete Copy) First two pages and last two pages with company’s sign and seal
    5. AOA (Complete Copy) First two pages and last two pages with company’s sign and seal
    6. Directors Details (DIN) with Seal and Signature in company's letterhead
    7. Share Certificate or Share Allotment Details with Seal and Signature in company’s letterhead
    8. Board of Resolution with Seal and Sign by Minimum 2 Directors in company's letterhead. (Available in our website for download)
    9. PAN copy of the company
    10. GST registered documents
    11. Pan copies of all the Directors
    12. Aadhaar copies of all the Directors
  • DECLARATION AND UNDERTAKING

     

    I Mr/Ms {decFirst} {decLast} ID# ______________solemnly affirm and declare as follows:
    OR
    We, M/s.  {weMs}  , represented by its Sole Proprietor / Managing Partner / Authorized Director,
    Mr.
    {soleProprietor281} , solemnly affirm and declare as follows: -

    1. Based on our estimated aggregate annual turnover from sale and provision of all goods and services, we are not required to register ourselves under Central Goods and Services Act, 2017 or the applicable State GST laws, since our said estimated aggregate annual turnover falls below the prescribed threshold / exemption limit applicable to us in our State.

    2. We undertake that in case for any reason our actual aggregate annual turnover exceeds the said applicable prescribed threshold / exemption limit in any financial year, we shall immediately and forthwith register ourselves under the applicable GST laws and comply with the requirements of GST for charging the same and depositing with the GST authorities.

    3. We shall keep Enagic India Kangen Water Private Limited (“Company”) including its directors, officers, representatives, servants and agents (collectively “Indemnified Parties”) fully indemnified and hold them harmless for all times to come in respect of any claim, loss, damage or penalty that may be suffered or incurred by Indemnified Parties or any of them in respect of our non-compliance or violation of any of our undertaking as contained in Clause 2 herein above and/or our declaration as contained in Clause 2 above to be incorrect or misleading in any respect.

    4. We confirm that in respect of our above declaration and undertaking and the indemnity obligations, the Company shall be fully entitled to retain or withhold such amount from out of our entitlements from the Company as the Company may deem fit until we provide necessary evidence and proof of our due compliance of the GST laws and requirements, to the entire satisfaction of the Company.

    5. We also further confirm that the Company shall be fully entitled to and it will be within the rights of the Company to set off and adjust the withheld amount as per Clause 2 herein above against or towards any loss, claim, damage, penalty, etc, that may be suffered or incurred by the Indemnified Parties or any of them due to our non-compliance of GST laws, rules and regulations or due to any reason attributable to us.

    6. We also agree and confirm that while all matters arising out of this Declaration and Undertaking shall be subject to the exclusive jurisdiction of the courts at Bangalore alone, any dispute under this Declaration and Undertaking or in any manner connected to it shall be resolved through arbitration by a sole arbitrator to be appointed by the Director of the Company who may be authorized by the Board of Directors of the Company in this regard. The venue of arbitration shall be Bangalore and the arbitration proceedings shall be conducted in English language.

    Solemnly affirmed, declared, undertaking and executed on this , {todaysDate179}, at {atCity} (City).

    To, Enagic India Kangen Water Pvt.Ltd.

     

     {signature}

    DEPONENT / DECLARANT
    [Signature with Seal]

  • Terms and Conditions
  • I Agree, This online form processing systems has been made for Fit Bharat Mission Team Members to make this process simpler and faster, I agree FTM to submit all my signed documents to Enagic India on behalf of me with required Sponsor and sales facilitator details and all above mentioned details are true. *
  • APPLICANT'S SIGNATURE P4 DATE
     - -
  • APPLICANT'S SIGNATURE P5 DATE
     - -
  • Referred by

    Who referred this product to you ?
  • 0/50
  • SIGNATURE SECTION

  • FOR OFFICE USE ONLY

  • Do you Know Sponsor Name and ID for this Application ?*
  • Resend Email Link for Sponsor's Signature
  • ReSend Email

     {typeA}

  • Should be Empty: